| NPI | 1053756940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Q4912) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX Q4912) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-02-02 |